Yes ! I would like to participate in the NorthCoast EFT (Electronic Funds Transfer) program. Mail this form at least six days before requested start date.

I give Bristol View Homeowners Association, Inc. permission to debit my checking account for my Assessment Charge monthly and to change this amount upon at least 30 days notice. I am enclosing a voided check.

I would prefer to have my assessments debited from my account on the (Please select one):
     1st day of the month             10th day of the month       Start Month: __________________

Please note: if the 1st or the 10th falls on a holiday or weekend, your debit will occur on the first business day following the 1st or the 10th day.

This electronic funds transfer arrangement may be cancelled at any time upon at least 10 days written notice to NorthCoast Corp.

___________________________         _____________________________         _______________
Signature                                                 Number and Street                                      Date

..........................................................................................................................................................................

Yes ! I would like to participate in the NorthCoast EFT (Electronic Funds Transfer) program. Mail this form at least six days before requested start date.

I give Bristol View Homeowners Association, Inc. permission to debit my checking account for my Assessment Charge monthly and to change this amount upon at least 30 days notice. I am enclosing a voided check.

I would prefer to have my assessments debited from my account on the (Please select one):
     1st day of the month             10th day of the month       Start Month: __________________

Please note: if the 1st or the 10th falls on a holiday or weekend, your debit will occur on the first business day following the 1st or the 10th day.

This electronic funds transfer arrangement may be cancelled at any time upon at least 10 days written notice to NorthCoast Corp.

___________________________         _____________________________         _______________
Signature                                                 Number and Street                                      Date